Journal Article

Income-related inequality in quality-adjusted life expectancy in Korea at the national and district levels

Park, Jong Heon, Ock, Minsu, Khang, Young-Ho, Lim, Dohee, Bahk, Jinwook, Kim, Yeon-Yong, Kim, Ikhan, Kang, Hee-Yeon

2020

Overview

Background The aim of this study was to measure differences in quality-adjusted life expectancy (QALE) by income in Korea at the national and district levels. Methods Mortality rates and EuroQol-5D (EQ-5D) scores were obtained from the National Health Information Database of the National Health Insurance Service and the Korea Community Health Survey, respectively. QALE and differences in QALE among income quintiles were calculated using combined 2008–2014 data for 245 districts in Korea. Correlation analyses were conducted to investigate the associations of neighborhood characteristics with QALE and income gaps therein. Results QALE showed a graded pattern of inequality according to income, and increased over time for all levels of income and in both sexes, except for low-income quintiles among women, resulting in a widened inequality in QALE among women. In all 245 districts, pro-rich inequalities in QALE were found in both men and women. Districts with higher QALE and smaller income gaps in QALE were concentrated in metropolitan areas, while districts with lower QALE and larger income gaps in QALE were found in rural areas. QALE and differences in QALE by income showed relatively close correlations with socioeconomic characteristics, but relatively weak correlations with health behaviors, except for smoking and indicators related to medical resources. Conclusions This study provides evidence of income-based inequalities in health measured by QALE in all subnational areas in Korea. Furthermore, QALE and differences in QALE by income were closely associated with neighborhood-level socioeconomic characteristics.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adult / Calendars / Correlation analysis / Demographic aspects / Economic Status / Equality / Female / Gender / Gender equality / Health aspects / Health disparities / Health insurance / Health Status Disparities / Health Surveys / Humans / Income / Income - classification / Income - statistics & numerical data / Income distribution / Inequality / Life Expectancy / Life span / Male / Medicine / Medicine & Public Health / Metropolitan areas / Middle Aged / Mortality / National health insurance / Neighborhoods / Online databases / Personal income / Population / Quality of Life / Quality of Life Research / Questionnaires / Republic of Korea / Residence Characteristics - statistics & numerical data / Rural areas / Sex Distribution / Socioeconomic factors / Socioeconomics / Studies / Time / Women